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Doctor insights on:
Postherpetic Neuralgia

1

Nerve Damage:
A painful condition that follows a bout of shingles or herpes zoster. This occurs in people that have had chicken pox earlier in life when the virus reactivates in their nervous system..An immunization is available for patients over 50 to reduce the chance of this reactivation happening. Condition is not generally seen in younger people unless they are immunocompromised or under unusual stress.
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Can also be described as neuropathic pain or "nerve pain" which can occur anywhere in the body. It can also be due to many disorders such as direct nerve damage, diabetes, trigeminal neuralgia, or infection.
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2

Post herpetic neural:
The words only mean pain related to having had shingles.Noted after the shingles has healed. If you have a rash then one ay see it but more often than not the rash is long done.
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4

Pain:
Postherpetic neuralgia is fancy doctor talk for residual pain left over after the shinglesrash has gone away. Post means after, herpetic means related to herpes-and shingles is caused by a herpes zostervirus, and neuralgiai s another word for nerve related pain. Not all patients who suffer from shingles get the resultant postherpetic neuralgia.
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5

Common:
Shingles is latent chicken pox virus that affects a single nerve when it is exacerbated. Even though shingles is common, post herpatic neuralgia is less so. With proper initial treatment the complication can be minimized but not eliminated.
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6

A and B:
A. Duration 7 to 14 days, average 10
b. Severe burning pain in distribution of rash which may persists for days to months or years, long after rash has resolved. In the absence of a definite skin rash at any time, diagnosis of post-herpetic neuralgia is suspect.
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10

Shingles & PHN.:
The best chance of preventing PHN would be to start an appropriate anti viral medication (Valtrex (valacyclovir) or Famvir) within 48 hours of noticing the rash. Otherwise, you have to hope for the best. The occurrence of PHN is generally unpredictable.
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14

Yes indicated:
Herpes zoster ' shingles' after blisters healed in some will have severe disabling pains will lost for months and months which most likely you have involving one of the trigeminal nerve branch, the virus stays in nerve root for ever. Image guided cervicothoracic sym. Ganglion block along with t.N block most likely will help your pain , is relatively low risk procedure in trained hands.
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19

YES!:
Antivirals, like valtrex, (valacyclovir) need to be started within 72 hrs of shingle symptoms. They can decrease the severity and duration of the rash. If pain persists after the rash is gone - postherpetic neuralgia (phn) - it needs to be treated aggressively so it does not last forever. The older you are when you have shingles, the more likely you are to have phn. See a board certified pain specialist for help.
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20

Neurologist:
Post-herpetic neuralgia can be very painful. There are several medications that may be able to help with the pain. Neurontin (gabapentin) is one of the 1st line medications that has some efficacy. There are other medications that your neurologist may recommend that may help decrease the pain.
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